1.Analysis of ethical dilemmas and coping strategies for the establishment of human milk banks in hospitals
Yao JIN ; Zhenyan FU ; Huixiang SHANG ; Lijuan WEI ; Chi HUANG ; Juan CHEN ; Mingtao QUAN
Chinese Medical Ethics 2025;38(11):1441-1446
Breast milk is the optimal natural food for newborns. However, some newborns cannot receive maternal breast milk due to reasons such as mother-infant separation or insufficient lactation. The establishment of human milk banks (HMB) can effectively address these issues, thereby increasing the breastfeeding rate among hospitalized newborns and improving their quality of survival. However, HMB in China is still in the development and improvement stage. Its implementation involves a series of ethical issues, such as informed consent, privacy protection, economic incentives, quality and safety, and fair resource distribution, which hinder HMB’s widespread promotion. Therefore, discussing the ethical dilemmas faced by the widespread establishment of HMB in China’s hospitals and analyzing coping strategies are crucial for improving the breastfeeding rate of newborns. This paper deeply analyzed and sorted out the ethical issues and challenges currently faced by HMB in China, and proposed corresponding strategies, including “ensuring informed consent and voluntary participation of both donors and recipients,” “protecting the privacy of donors and recipients,” “establishing an ethics-based moral incentive and social support system,” “strictly controlling quality and safety issues”, and “developing fair and rational policies,” aiming to provide a reference solution for addressing ethical concerns in the establishment and operation of HMB.
2.Efficacy of Xingpi Huazhuo Prescription in treating pre-diabetic patients with phlegm-dampness constitution and its influences on blood glucose and renal function indexes
Lijuan LI ; Jie WU ; Xinxiu SHANG ; Weixun FENG
Journal of Clinical Medicine in Practice 2025;29(4):60-63
Objective To investigate the efficacy of Xingpi Huazhuo Prescription in treating pre-diabetic patients with phlegm-damp constitution and its impacts on blood glucose levels and renal func-tion indicators.Methods A total of 104 pre-diabetic patients with phlegm-damp constitution admitted to the hospital between January 2021 and December 2023 were selected and randomly divided into west-ern medicine group(n=52)and combined group(n=52)using a random number table method.The western medicine group received metformin treatment,while the combined group received metformin combined with Xingpi Huazhuo Prescription.Clinical efficacy was recorded after 3 months of treatment,and blood glucose indexes such as[fasting blood glucose(FPG),glycated hemoglobin(HbA1c),and 2-h plasma glucose(2 hPG)]levels,lipid indicators[triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],and renal function indicators[serum creatinine(Scr),urea nitrogen(BUN),β2-microglobulin(β2-MG)]were compared before and after 3 months of treatment.Results After 3 months of treatment,the total clinical effectiveness in the combined group was higher than that in the western medicine group(P<0.05).After 3 months of treatment,the levels of FPG,HbA1c,and 2 hPG decreased in both groups,and the combined group showed lower levels than the western medicine group(P<0.05).After 3 months of treatment,the levels of TG,TC,and LDL-C decreased in both groups compared with before treatment,and the combined group showed lower levels than the western medicine group(P<0.05);the levels of HDL-C increased in both groups,and the combined group showed higher levels than the western medicine group(P<0.05).After 3 months of treatment,the levels of Scr,BUN,and β2-MG decreased in both groups,with the combined group showing lower levels than the western medicine group(P<0.05).Conclusion In pre-diabetic patients with phlegm-damp con-stitution,metformin combined with Xingpi Huazhuo Prescription can effectively improve blood glu-cose levels and exert renal protective effects.
3.Progress in immune mechanism of NLRP3 inflammasome in pathogenesis of myelodysplastic syndrome
Ying SHANG ; Lijuan LI ; Liansheng ZHANG
Chinese Journal of Immunology 2025;41(8):2032-2037
NLRP3 inflammasome plays an important role in immune microenvironment of myelodysplastic syndromes(MDS)and is a key component of innate immune system.NLRP3 inflammasome participates in inflammatory regulation of MDS by producing pro-inflammatory factors IL-1β and IL-18 and Caspase-1-mediated cell pyroptosis.In bone marrow microenvironment,DAMPs and related genes can activate inflammasome,leading to dysregulation of innate immune system.Therefore,NLRP3 inflammasome may be an effective therapeutic target for MDS.This review studies structure,function,activation mechanism and immune regulation of NLRP3 inflammasome in MDS and explored its potential as a therapeutic target for MDS.
4.Effect of LncRNA CTBP1-AS2 on malignant biological behavior of acute myeloid leukemia cells by regulating miR-433-3p/DPP8 signaling axis
Suhui LIU ; Lijuan DUAN ; Chao LI ; Fan QIN ; Miao SHANG
Chinese Journal of Immunology 2025;41(11):2631-2636
Objective:To investigate effect of LncRNA C-terminal binding protein 1 antisense RNA 2(CTBP1-AS2)on malig-nant biological behavior of acute myeloid leukemia(AML)cells by regulating miR-433-3p/dipeptidyl peptidase 8(DPP8)signaling axis.Methods:AML cells HL-60 were randomly separated into si-NC group,si-CTBP1-AS2 group,si-CTBP1-AS2+anti-NC group,and si-CTBP1-AS2+anti-miR-433-3p group.CCK-8 method and EdU staining were applied to detect HL-60 cell proliferation.Flow cytometry was applied to detect HL-60 cells apoptosis.Transwell was applied to detect migration and invasion of HL-60 cells.Western blot was applied to detect expressions of PCNA,Bax,MMP-9 and DPP8 proteins in HL-60 cells.ELISA was applied to detect expres-sions of IFN-γ and IL-1β.Dual luciferase reporter gene experiment was applied to analyze interaction between LncRNA CTBP1-AS2 and miR-433-3p,and between miR-433-3p and DPP8.Results:Expressions of LncRNA CTBP1-AS2,DPP8 mRNA,A450,EdU posi-tive cells,number of migrating cells,number of invading cells,PCNA protein,MMP-9 protein,DPP8 protein and IL-1β protein ex-pressions of HL-60 cells in si-CTBP1-AS2 group were lower than si-NC group,miR-433-3p expression,apoptosis rate,Bax protein and IFN-γ protein expressions were higher than si-NC group(P<0.05).Compared with si-CTBP1-AS2 group and si-CTBP1-AS2+anti-NC group,miR-433-3p expression,apoptosis rate,and expressions of Bax protein and IFN-γ protein in si-CTBP1-AS2+anti-miR-433-3p group were decreased,DPP8 mRNA,A450,EdU positive cells,number of migrating cells,number of invading cells,PCNA protein,MMP-9 protein,DPP8 protein and IL-1β protein expressions were increased(P<0.05).LncRNA CTBP1-AS2 targeted negative regula-tion of miR-433-3p,while miR-433-3p targeted negative regulation of DPP8.Conclusion:Knocking down LncRNA CTBP1-AS2 may inhibit malignant biological behavior of AML cells,whose mechanism may be achieved by regulating miR-433-3p/DPP8 signaling axis.
5.Progress in immune mechanism of NLRP3 inflammasome in pathogenesis of myelodysplastic syndrome
Ying SHANG ; Lijuan LI ; Liansheng ZHANG
Chinese Journal of Immunology 2025;41(8):2032-2037
NLRP3 inflammasome plays an important role in immune microenvironment of myelodysplastic syndromes(MDS)and is a key component of innate immune system.NLRP3 inflammasome participates in inflammatory regulation of MDS by producing pro-inflammatory factors IL-1β and IL-18 and Caspase-1-mediated cell pyroptosis.In bone marrow microenvironment,DAMPs and related genes can activate inflammasome,leading to dysregulation of innate immune system.Therefore,NLRP3 inflammasome may be an effective therapeutic target for MDS.This review studies structure,function,activation mechanism and immune regulation of NLRP3 inflammasome in MDS and explored its potential as a therapeutic target for MDS.
6.Effect of LncRNA CTBP1-AS2 on malignant biological behavior of acute myeloid leukemia cells by regulating miR-433-3p/DPP8 signaling axis
Suhui LIU ; Lijuan DUAN ; Chao LI ; Fan QIN ; Miao SHANG
Chinese Journal of Immunology 2025;41(11):2631-2636
Objective:To investigate effect of LncRNA C-terminal binding protein 1 antisense RNA 2(CTBP1-AS2)on malig-nant biological behavior of acute myeloid leukemia(AML)cells by regulating miR-433-3p/dipeptidyl peptidase 8(DPP8)signaling axis.Methods:AML cells HL-60 were randomly separated into si-NC group,si-CTBP1-AS2 group,si-CTBP1-AS2+anti-NC group,and si-CTBP1-AS2+anti-miR-433-3p group.CCK-8 method and EdU staining were applied to detect HL-60 cell proliferation.Flow cytometry was applied to detect HL-60 cells apoptosis.Transwell was applied to detect migration and invasion of HL-60 cells.Western blot was applied to detect expressions of PCNA,Bax,MMP-9 and DPP8 proteins in HL-60 cells.ELISA was applied to detect expres-sions of IFN-γ and IL-1β.Dual luciferase reporter gene experiment was applied to analyze interaction between LncRNA CTBP1-AS2 and miR-433-3p,and between miR-433-3p and DPP8.Results:Expressions of LncRNA CTBP1-AS2,DPP8 mRNA,A450,EdU posi-tive cells,number of migrating cells,number of invading cells,PCNA protein,MMP-9 protein,DPP8 protein and IL-1β protein ex-pressions of HL-60 cells in si-CTBP1-AS2 group were lower than si-NC group,miR-433-3p expression,apoptosis rate,Bax protein and IFN-γ protein expressions were higher than si-NC group(P<0.05).Compared with si-CTBP1-AS2 group and si-CTBP1-AS2+anti-NC group,miR-433-3p expression,apoptosis rate,and expressions of Bax protein and IFN-γ protein in si-CTBP1-AS2+anti-miR-433-3p group were decreased,DPP8 mRNA,A450,EdU positive cells,number of migrating cells,number of invading cells,PCNA protein,MMP-9 protein,DPP8 protein and IL-1β protein expressions were increased(P<0.05).LncRNA CTBP1-AS2 targeted negative regula-tion of miR-433-3p,while miR-433-3p targeted negative regulation of DPP8.Conclusion:Knocking down LncRNA CTBP1-AS2 may inhibit malignant biological behavior of AML cells,whose mechanism may be achieved by regulating miR-433-3p/DPP8 signaling axis.
7.Application of a machine learning-assisted prescription rationality prediction model in perioperative rational drug use management
Lijuan FAN ; Zhiqi ZHANG ; Xiaojun CHENG ; Xiunan YUE ; Haiyan CHENG ; Nan SHANG
Chinese Journal of Pharmacoepidemiology 2024;33(11):1219-1228
Objective To explore the influencing factors of rational perioperative drug use,and to establish a rationality prediction model based on machine learning to assist pharmacists in prescription review.Methods A retrospective analysis was conducted on the perioperative prescription data of neurosurgery patients from a tertiary hospital and a central hospital in Shanxi Province between March 2021 and March 2023.Univariate analysis and multivariate Logistic regression were initially used to identify factors influencing rational drug use,followed by Lasso regression and multicollinearity analysis to select important variables.The data was split into a training set and test set at a ratio of 7∶3,and decision tree(DT),multi-layer perceptron(MLP),extreme gradient boosting(XGBoost),support vector machine(SVM),and random forest(RF)learning models were constructed.Results A total of 1 500 prescriptions were included,of which 668 were classified as rational and 832 as irrational.In both the training and test sets,the AUC values of the DT,XGBoost,and RF models exceeded 0.9.The DT model showed the highest sensitivity(0.81),while the RF model demonstrated the highest specificity(0.90).In the RF model,the number of comorbidities,preoperative waiting time,total hospitalization cost,prescribing physician's title,and adverse reaction occurrence negatively impacted prescription rationality,whereas the number of drugs,age,and administration route positively influenced rationality.Conclusion The machine learning-based rational drug use prediction model demonstrates strong predictive performance,effectively assisting pharmacists in prescription review and helping to reduce the incidence of irrational drug use.
8.Association between sedentary behaviors with cardiorespiratory fitness and executive function among adolescents
SHANG Wenjin, YIN Xiaojian, WANG Jinxian, HONG Jun, SHI Lijuan, GUO Junfeng, WANG Tianyi, LIU Yixuan
Chinese Journal of School Health 2024;45(3):330-334
Objective:
To explore the relationship between sedentary behavior with cardiorespiratory fitness and executive function in adolescents, and to provide some references for sedentary behavior prevention and executive function improvement.
Methods:
From September to December 2022, a total of 5 018 adolescents aged 13 to 18 years were selected by stratified random sampling method in Shanghai, Suzhou, Taiyuan,Wuyuan, Xingyi, and Urumqi to conduct physical activity survey, as well as cardiorespiratory fitness and executive function assessment. Pearson s correlation was used to analyze the relationship between sedentary behavior, cardiorespiratory fitness and executive function. The mediation effect model was fitted by the bootstrap mediation procedure in the PROCESS (version 3.3 ) SPSS macro compiled by Haves, and the mediation effect of adolescents cardiorespiratory fitness in the relationship between static behavior and executive function was examined using model 4 in the PROCESS SPSS macro, where Boosrap method was used to compute the mediation effect of adolescents cardiorespiratory fitness. where the Boosrap method was used to calculate confidence intervals for the mediating effects.
Results:
Adolescents daily sedentary time was positively correlated with both the refreshing function (1-back and 2-back) and the switch function reaction time ( r =0.05, 0.07, 0.05, P <0.01). Adolescent VO 2max was negatively correlated with both the refreshing function (1-back,2-back) and the switching function ( r =-0.09, -0.14 , -0.11, P <0.01). Adolescents daily sedentary time was negatively correlated with VO 2max ( r =-0.04, P <0.01); cardiorespiratory fitness mediated effect values between sedentary behavior and refreshing function (1-back and 2-back) and converted function were 0.20(95% CI =0.06-0.36), 0.43(95% CI =0.14-0.74) and 0.13 (95% CI =0.04-0.22), with mediating effect shares of 6.87%, 8.33% and 8.59%, respectively.
Conclusion
The duration of sedentary behavior in adolescents is related to executive function performance, and cardiorespiratory fitness may serve as a mediator to mediate the association between sedentary behavior and executive function in adolescents.
9.Diagnosis, treatment and prevention of severe acute respiratory syndrome coronavirus 2 infection in children: experts′ consensus statement (Fifth Edition)updated for the Omicron variant
Rongmeng JIANG ; Zhengde XIE ; Yi JIANG ; Xiaoxia LU ; Runming JIN ; Yuejie ZHENG ; Yunxiao SHANG ; Baoping XU ; Zhisheng LIU ; Gen LU ; Jikui DENG ; Guanghua LIU ; Xiaochuan WANG ; Jianshe WANG ; Luzhao FENG ; Wei LIU ; Yi ZHENG ; Sainan SHU ; Min LU ; Wanjun LUO ; Miao LIU ; Yuxia CUI ; Leping YE ; Adong SHEN ; Gang LIU ; Liwei GAO ; Lijuan XIONG ; Yan BAI ; Likai LIN ; Zhuang WEI ; Fengxia XUE ; Tianyou WANG ; Dongchi ZHAO ; Zhengyan ZHAO ; Jianbo SHAO ; Wong Wing-kin GARY ; Yanxia HE ; Xingwang LI ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2023;38(1):20-30
China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.
10.Expert consensus on the diagnosis, treatment and prevention of monkeypox in children
Rongmeng JIANG ; Yuejie ZHENG ; Lei ZHOU ; Luzhao FENG ; Lin MA ; Baoping XU ; Hongmei XU ; Wei LIU ; Zhengde XIE ; Jikui DENG ; Lijuan XIONG ; Wanjun LUO ; Zhisheng LIU ; Sainan SHU ; Jianshe WANG ; Yi JIANG ; Yunxiao SHANG ; Miao LIU ; Liwei GAO ; Zhuang WEI ; Guanghua LIU ; Gang LIU ; Wei XIANG ; Yuxia CUI ; Gen LU ; Min LU ; Xiaoxia LU ; Runming JIN ; Yan BAI ; Leping YE ; Dongchi ZHAO ; Adong SHEN ; Xiang MA ; Qinghua LU ; Fengxia XUE ; Jianbo SHAO ; Tianyou WANG ; Zhengyan ZHAO ; Xingwang LI ; Yonghong YANG ; Kunling SHEN
Chinese Journal of Applied Clinical Pediatrics 2022;37(13):964-973
Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.


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